Gout, a little-known type of arthritis, can cause searing pain in your toes, feet and other joints. If you’re at risk – and you might be if a relative suffers from the disorder – it can come on with little warning. Read on to learn about the best gout remedies available, as well as alternative treatments that relieve gout pain while limiting side effects…

Gout isn’t making a comeback – it just never went away.

You may think this illness, once known as “rich man’s disease” because it was thought to come from eating fatty foods, disappeared with Charles Dickens.

In fact, it’s the most common inflammatory arthritis in men over 30 – and women are just as susceptible after menopause.

It often comes on suddenly in the night, turning your big toe (or another joint) into a poker of pain – red, hot and swollen.

Gout is caused by a buildup of uric acid – a waste product left by dead cells – in the blood, either because your body produces too much or excretes too little.

The uric acid eventually crystallizes, forming tiny needles that work into joints, leading to intense pain and swelling.

“One theory about why gout pain occurs early in the morning is that the foot is coolest at those hours, and [uric acid] goes from its liquid phase in the blood to crystals that establish themselves in the joint,” says rheumatologist Nathan Wei, M.D., director of the Arthritis and Osteoarthritis Treatment Center of Frederick, Md.

The condition is mostly hereditary, Wei says.

But some foods – such as organ meats and beer – can increase uric-acid buildup because they contain high levels of compounds called purines, which convert to uric acid in the body.

Consuming lots of meat, seafood and alcohol may also increase gout risk.

While gout remedies ease symptoms, they can’t cure the condition. They reduce uric acid levels in the blood and banish pain that accompanies a gout attack.

Here are the best doctor-recommended treatments – both medical and natural – for gout.

Conventional Gout Remedies

Gout Remedies: Anti-inflammatories“The first step is to get the attack under control,” says Zorba Paster, M.D., and clinical professor in the School of Medicine and Public Health at the University of Wisconsin in Madison, who hosts a weekly call-in show on Public Radio International.

That’s why doctors often recommend a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen, that reduces levels of pain- and inflammation-causing chemicals called prostaglandins.

If your doctor approves, take double the normal dose of over-the-counter ibuprofen (Advil, Motrin) or naproxen (Aleve) for the first 2-3 days, Paster advises.

Prescription NSAIDs, like indomethacin (Indocin, Indocin-SR), are available for gout pain too, but they function the same as over-the-counter medications, he says.

After several days of double doses, your doctor probably will suggest a lower dose to ward off more attacks.

But don’t take NSAIDs long-term without a doctor’s input because they can trigger serious side effects, such as gastrointestinal bleeding and heart problems.

“During the first six months patients are on gout medications that reduce uric acid levels, they’re prone to develop acute attacks – although we don’t know why,” he says.

“So we give patients colchicine for six months and discontinue it. It’s remarkably good for keeping inflammatory cells from multiplying.”

However, many physicians prefer NSAIDs because colchicine can cause nasty side effects, such as stomach cramps and diarrhea.

“It helps pain, but it makes you feel miserable,” Wei says.

Gout Remedies: SteroidsFor people who can’t tolerate colchicine or must avoid NSAIDs because of kidney or liver disease, a doctor might prescribe steroid hormones, such as prednisone, to control inflammation and gout pain.

“You can give [oral] steroids over a few days,” then taper off rapidly, Wei says. That’s because steroids have severe side effects, such as nervousness and insomnia, and raise your risk of infection.

Over time, they can thin bones too. If gout pain affects only a single joint, the physician may use a small needle to remove fluid and then inject a steroid into the joint to ease inflammation immediately.

Gout Remedies: Probenecid (Benemid, Probalan)Part of a class of drugs called uricosurics, probenecid increases excretion of uric acid by preventing a kidney protein from transporting it back into the body.

But doctors won’t prescribe probenecid until an acute attack is over. That’s because it could exacerbate symptoms.

As with other uric-acid-reducing drugs, the frequency of gout attacks may increase during the first few months.

“Probenecid is good for people under middle age unless they have kidney stones,” Wei says. “The increased [urination] makes kidney stones worse.” (Patients on probenecid should drink at least eight glasses of water each day to reduce kidney-stone risk.)

Gout Remedies: Allopurinol (Aloprim, Zyloprim)Approved in 1964,this older medication can reduce uric acid production, says Harris H. McIlwain, M.D., a rheumatologist with the Tampa Medical Group in Florida, and co-author of Diet for a Pain-Free Life (Da Capo Press).

Allopurinol has a long track record of effectiveness and is relatively inexpensive.

But it can cause upset stomach, diarrhea and sleepiness or more serious effects, like bone marrow suppression or hepatitis, says Wei.

Drink at least eight glasses of water a day while taking it, and avoid alcohol, which can diminish its effect.

Gout Remedies: Febuxostat (Uloric)Approved in 2009, febuxostat is the first all-new gout medication in 45 years. Like allopurinol, it’s designed to reduce uric acid production.

To control gout, uric-acid levels have to fall and remain below 6 milligrams (mg) per deciliter (dL) of blood, explains Paster, who has done research on the new drug. “Uloric is more effective in getting levels below 6 mg/dL,” he says. “And if you keep levels [that low], you can [nearly] get rid of attacks.”

The drug is also more effective at dissolving tophi, uric-acid nodules that form under the skin in cases of chronic gout, Paster says.

Febuxostat also appears to have fewer potential side effects than allopurinol, Wei says. But it still may cause liver problems, nausea, rash, joint pain and cardiovascular issues. It’s also more expensive, which means insurance companies are likely to cover allopurinol first.

Natural Gout RemediesDon’t tackle gout without medication, because you may have increasing attacks, higher risk of kidney stones and kidney disease and tophi knots on the elbows, fingers and knees.

But some natural gout remedies may relieve gout pain and decrease frequency and severity of attacks.

Gout Remedies: AcupunctureBeing stuck by needles is probably the last thing you want during a gout attack. But several Chinese studies indicate the ancient therapy may relieve gout pain.

Acupuncture had a 93.3% effectiveness rate in alleviating pain, compared to 80% for gout medications like indomethacin and allopurinol, according to a 2009 Chinese study of 60 patients.

What’s more, the acupuncture group had no negative reactions, compared to 46.7% of those taking drugs.

How does it work?

“Acupuncture helps promote blood circulation as well as [expansion] of the small capillaries, allowing small uric acid crystals to be broken down and carried away,” says acupuncturist Tom Ingegno, L.Ac., co-owner of Ancient Arts Wellness in Baltimore, Md.

Although acupuncturists may place needles near a painful site, “we don’t jam a needle in the joint,” Ingegno says.

For acute pain, Ingegno recommends 2-3 hour-long sessions a week until it subsides.

For chronic gout patients, he recommends monthly or bimonthly treatments.

Gout remedies: Ice or heatFor some people, holding an ice pack or a bag of frozen peas on the painful joint for 15-20 minutes may relieve pain.

“But for [others], it makes pain worse,” Wei says.

In that case, try a moist heating pad, which might keep painful crystals from forming, he suggests.

Make a warm pad by soaking a dishcloth, stashing it in a microwave-safe plastic zipper bag, closing all but a tiny portion of the zipper, and heating it in the microwave on high for two minutes. Wrap the bag in a towel and put in on your joint.

“You’ll have a heating pad that stays warm for 15 minutes,” Wei says.

Gout remedies: CherriesCertain compounds in cherries called anthocyanins can reduce uric acid levels and ease inflammatory pain, according to studies at Tufts and Johns Hopkins Universities.

Eat a half cup of fresh cherries a day (dark-colored or “tart” varieties are best as gout remedies) or take cherry supplements, following directions on the package, Wei advises.

Gout remedies: WaterHydration is a gout sufferer’s best friend. Fluids help flush uric acid out of the body and prevent kidney stones – often a risk in people with gout. Drink at least eight 8-ounce glasses a day, particularly during gout attacks, Paster says.

Gout remedies: Bed Cradle This device forms a tent over painful feet to keep bed sheets from touching them during an acute attack of gout pain.

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